Care of the Developing Family
In genetic testing, which role would the nurse question performing? 1. Diagnosing a fetus with a genetic disorder 2. Identifying at-risk clients and families 3. Providing emotional support for the client and family 4. Providing a referral to support groups and genetic counseling services
1 1. Diagnosis of a disorder comes through genetic testing ordered by a provider or genetic counselor. 2. Nurses frequently work with clients to obtain histories and can identify at-risk clients and families. 3. Nurses provide emotional support and explain the grief process. 4. Nurses will work with clients and families and can provide referrals for community resources.
When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? 1. Call the pediatrician. 2. Start an IV on the infant. 3. Check the infant's pulse oximetry. 4. Listen to the infant's heart sounds.
1 1. Due to the risk of cardiovascular disease, calling the pediatrician is important in order to let the doctor know what is going on. 2. If an infant is medically stable, there is no reason to start an IV. 3. This is not an indication whether the infant is stable. 4. Though this is part of an assessment, it is not necessary for the next step.
In preparing a client for endometrial biopsy, the nurse stated that this procedure is usually performed at the end of the menstrual cycle. Which is the indication for doing this procedure during this time? 1. To assess the response of the uterus to hormonal signals that occur during the cycle 2. To detect a rapid increase in the luteinizing hormone 36 hours before ovulation 3. To detect tubal adhesions, fibroids, and uterine fistulas 4. To determine the size of the remaining egg reserve
1 1. Endometrial biopsy is done to assess the response of the uterus to hormonal signals that occur during the cycle. 2. Luteinizing hormone surge is done to detect a rapid increase in the luteinizing hormone 36 hours before ovulation. 3. A hysterosalpingogram is used to detect tubal adhesions, fibroids, and uterine fistulas. 4. Ovarian reserve testing is done to determine the size of the remaining egg reserve.
During which day of a typical 28-day menstrual cycle does the follicular phase occur? 1. Cycle days 1 to 13 2. Cycle days 15 to 28 3. Cycle day 14 4. Cycle day 1 to 5
1 1. The follicular phase is the phase when follicles in the ovary mature. It ends with ovulation. The main hormone controlling this stage is estradiol. The follicular phase begins on the first day of menstruation and ends with ovulation. 2. This is the Luteal phase (days 15 to 28). This phase begins on the fifteenth day and lasts until the end of the cycle. 3. This the ovulation phase. 4. This is the menstrual phase. The uterus sheds its inner lining of soft tissue and blood vessels, which exits the body from the vagina in the form of menstrual fluid.
A male client is seen at the provider's office for infertility. Which issue would the nurse question as a cause of male infertility? 1. Attending daily cycling classes at the local gym 2. Having an overweight body mass index 3. Smoking two to three cigarettes a day 4. Taking a calcium channel blocker for hypertension
2 1. Cycling can increase heat exposure to the testicles, which can affect the development of sperm. 2. Obesity is a risk factor for women with infertility, not for men. 3. Smoking can increase male infertility and affect development of sperm. 4. Calcium channel blockers can affect the development of mature sperm and can lead to infertility.
A couple was scheduled for an artificial insemination procedure. Which fertility condition does the nurse expect to find documented in the couple's medical record as a reason for needing this procedure? 1. Unexplained infertility 2. Diminished sperm motility 3. Bilaterally blocked fallopian tubes 4. Unsuccessful vasectomy reversal
2 1. Gamete intrafallopian transfer is a procedure used for unexplained infertility. 2. Artificial insemination is done when there is diminished sperm motility. 3. Embryo transfer is a procedure used for bilaterally blocked fallopian tubes. 4. Testicular sperm aspiration is done when vasectomy reversal is unsuccessful.
During a health assessment, a client was asked to state her last menstrual period. She replied, "This is my second day of having my menstrual flow." Which phase of the ovarian cycle would the nurse determine the client is in currently? 1. Luteal phase 2. Follicular phase 3. Proliferative phase 4. Ovulatory phase
2 1. The luteal phase begins after ovulation and lasts for 14 days. 2. The follicular phase begins the first day of menstruation and lasts 12 to 14 days. 3. The proliferative phase occurs following menstruation and ends with ovulation. 4. The ovulatory phase begins when estrogen levels peak and ends with the release of the oocyte.
Which STI can cause neonatal blindness? Select All. 1. Chlamydia 2. Gonorrhea 3. Syphilis 4. HIV
2 and 3: Syphilis and Gonorrhea can cause neonatal blindness.
During a teaching session, the nurse had a discussion on the issue of Y-linked inheritance. Which response by the father indicates that learning has taken place? 1. "The baby inherited the disease from my wife." 2. "My grand-aunt has the same condition." 3. "I passed on the condition to my baby." 4. "We both gave the baby our disease."
3 1. The baby's mother can be a carrier of the trait, but will not be able to pass on the condition. 2. The grand-aunt can be a carrier of the trait, but will not be able to pass on the condition. 3. The mutation is located only on the Y chromosome and can be passed only from father to son. 4. The mutation is located only on the Y chromosome; women cannot pass on the sex-linked trait.
Which is the first-line medication used to manage intrauterine fetal death? 1. Dinoprostone 2. Misoprostol 3. Mifepristone 4. Methylergonovine
1. Dinoprostone Dinoprostone is a synthetic derivative of the hormone prostaglandin E 2. It is used to manage intrauterine fetal death up to 28 weeks of gestational age. Misoprostol is used for cervical ripening, and it is used along with mifepristone to induce abortion. Methylergonovine is prescribed to reduce postpartum hemorrhage.
Which hormone may cause congenital defects in the female reproductive system? 1. Estrogen 2. Progesterone 3. Androgens 4. Diethylstilbestrol
1. Estrogen
Respiratory changes that take place during pregnancy include: 1. An increase or decrease in respiratory rate? 2. An increase or decrease in respiratory capacity? 3. An increase or decrease in expiratory volume? 4. Respiratory alkilosis or acidosis? 5. Any dyspnea? 6. Abdominal or thoracic breathing?
1. Increase 2. Increase 3. Decrease 4. Alkilosis 5. Yes, dyspnea occurs 6. Thoracic breathing
The following changes take place to the renal system during pregnancy: 1. Glomerular Filtration Rate (GFR) increases or decreases? 2. Renal Tubular Reabsorption increases or decreases? 3. Renal plasma flow increases or decreases? 4. Should proteinuria and glucosuria be reported to the health care provider?
1. Increases 2. Increases 3. Increases 4. No, they are normal during pregancy due to increased reabsorption
What are the four components of the Jonsen (AKA Four Quadrants/Topics) Method of ethical decision making?
1. Medical indications (Dx, prognosis, Tx options) 2. Patient Preferences (autonomy, informed consent) 3. Quality of Life (subjective to pt, automomy) 4. Contextual Features (social, cultural, economic, legal)
Which medication can be prescribed for the elective termination of a pregnancy? 1. Mifeprex 2. Raloxifene 3. Methylergonovine 4. Clomiphene
1. Mifeprex Mifeprex helps stimulate uterine contractions; this medication can be used for the elective termination of a pregnancy. Raloxifene may be used to prevent postmenopausal osteoporosis. Methylergonovine may be used to reduce postpartum uterine hemorrhage. Clomiphene may induce ovulation.
Which would the nurse identify as the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone? 1. Misoprostol 2. Mifepristone 3. Dinoprostone 4. Methylergonovine
1. Misoprostol Misoprostol is the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone because it is relatively affordable. Mifepristone is used to induce labor. Dinoprostone is used for cervical ripening but is not an off-label medication for cervical ripening. Methylergonovine is used to enhance myometrial tone but is not used to augment labor.
Which is the preferred medication of choice for the treatment of syphilis in a pregnant adolescent? 1. Penicillin G 2. Doxycycline 3. Tetracycline 4. Erythromycin
1. Penicillin G According to the Centers for Disease Control and Prevention, penicillin G is the preferred medication of choice for any stage of syphilis in pregnant women. Both doxycycline and tetracycline are contraindicated during pregnancy. Erythromycin may not be able to cure a fetal infection.
At about what week of pregnancy does a woman begin producting colostrum?
16 weeks
White blood cell counts may be as high as _______ cu. mm in the absence of infection
16,000 cu. mm
A couple visiting the clinic voiced their concern that their unborn baby might have Trisomy 21 at birth. Which test would the nurse recommend for this couple? 1. Carrier testing 2. Prenatal testing 3. Newborn screening 4. Preimplantation testing
2 1. Carrier testing is done when there is a family history of genetic disorders. 2. Prenatal testing allows for the early detection of genetic disorders such as Trisomy 21. 3. Newborn screening detects genetic disorders that can be treated early in life. 4. Preimplantation testing detects genetic changes in embryos that are created using assisted reproductive techniques.
During a written exam, a nursing student was asked to list the structures derived from the primary germ layers. The student states that the mucosa of the oral and nasal cavities is derived from the ectoderm. Which other statement about the primary germ made by the student is correct? 1. The mucosa of the esophagus, stomach, and intestines are developed from the mesoderm. 2. The bone marrow, blood, and lymphatic tissues are developed from the ectoderm. 3. The epidermis, hair, and nail follicles are developed from the ectoderm. 4. The lens, cornea, and internal ear are developed from the mesoderm.
3 1. The mucosa of the esophagus, stomach, and intestines are developed from the endoderm. 2. The bone marrow, blood, and lymphatic tissues are developed from the mesoderm. 3. The epidermis, hair, and nail follicles are developed from the ectoderm. 4. The lens, cornea, and internal ear are developed from the ectoderm.
The nurse is assessing a newborn at birth. When assessing the umbilical cord, she should expect to see how many vessels? 1. One 2. Two 3. Three 4. Four
3 1. The umbilical cord has two arteries and a vein. Therefore, finding one vessel is not normal. 2. The umbilical cord has two arteries and a vein. Therefore, finding two vessels is not normal. 3. The umbilical cord has two arteries and a vein. 4. The umbilical cord has two arteries and a vein. Therefore, finding four vessels is not normal.
A pregnant client is about to undergo an elective abortion. She has consented to the harvesting of fetal tissue. The nurse notifies the manager that she finds the harvesting morally wrong. Which is the manager's best response? 1. "I'm sorry you feel that way, you still have to assist." 2. "This is about the client, not your judgement." 3. "I will have another nurse assist with the procedure." 4. "I agree with you, harvesting fetal tissue is wrong."
3. "I will have another nurse assist with the procedure."
A nurse is discussing infant morbidity and mortality with a student nurse. Which statement by the student nurse would indicate understanding of infant mortality? 1. "Infant mortality is death at birth." 2. "Infant mortality is death before birth." 3. "Infant mortality is death before the first birthday." 4. "Infant mortality is death before the first month."
3. "Infant mortality is death before the first birthday."
Which pregnant client would be at the highest risk for alcohol use? 1. A 19-year-old African American 2. A 24-year-old Hispanic 3. A 30-year-old Caucasian 4. A 17-year-old Pacific Islander
3. A 30-year-old Caucasian ------- 1. African Americans age 18 to 25 have the 3rd highest incidence of alcohol use. 2. Hispanics age 18 to 25 have the 2nd highest incidence of alcohol use. 3. Caucasians age 26 to 34 have the highest incidence of alcohol use. 4. Pacific Islanders age 16 to 17 have a lower incidence of alcohol use.
During a prenatal intake a client admits to smoking marijuana daily. The nurse's only option, while functioning as an advocate, is to: 1.Report her substance abuse to the police department 2.Have the patient committed to a substance abuse center 3.Encourage the client to stop and provide information for recovery 4.Report the client to the public health department
3. Encouraging the client to stop smoking Marijuana and providing recovery information is the only option when functioning as an advocate. ------- 1. Because of HIPAA, the nurse is not allowed to call the police unless the patient is a danger to herself or others. 2. The nurse can encourage the client to go to a substance abuse center, but not commit. 3. Encouraging the client to stop smoking Marijuana and providing recovery information is the only option when functioning as an advocate. 4. The only information mandated to report to the health department is STIs and infectious diseases.
The nurse is caring for a 19-year-old primigravida who has no health insurance or support system. Which ethical principle guides the nurse to provide the same care to this client as other clients on the unit? 1. Autonomy 2. Fidelity 3. Justice 4. Beneficence
3. Justice
A client in active labor who is 90% effaced, 7 cm dilated with the vertex presenting at 2+ station, complains of pain and asks for medication. Which medication would the nurse anticipate causing respiratory depression in the newborn? 1. Naloxone 2. Lorazepam 3. Meperidine 4. Promethazine
3. Meperidine Meperidine is an opioid that can cause respiratory depression in the neonate if administered less than 4 hours before birth. Naloxone is an opioid antagonist that reverses the effects of respiratory depression in the newborn. Lorazepam is a sedative; it does not cause respiratory depression in the newborn, but it does not relieve pain by itself. Promethazine is a tranquilizer; it does not cause respiratory depression in the newborn. Promethazine does not relieve pain by itself.
Which of the following medications is an abortion pill? 1. Oxytocin 2. Misoprostol 3. Mifepristone 4. Methylergonovine
3. Mifepristone Mifepristone activates uterine contractions and causes abortion. This drug is used in the voluntary termination of pregnancy and is known as the abortion pill. Pregnant women are sensitive to oxytocin, which causes uterine contractions and may lead to abortion. Misoprostol is a synthetic prostaglandin usually given with mifepristone. Methylergonovine is an ergot alkaloid used to treat postpartum hemorrhage.
Which medication may be used both for cervical ripening during labor and as a stomach protectant? 1. Raloxifene 2. Clomiphene 3. Misoprostol 4. Dinoprostone
3. Misoprostol Misoprostol can be used for cervical ripening and as a stomach protectant. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used for ovulation. Dinoprostone can be used for cervical ripening, but this medication does not act as a stomach protectant.
The nurse is caring for a pregnant teenage client who is abusing drugs. Which ethical principle will the nurse consider when planning the client's educational activity on the consequences of drug abuse during pregnancy? 1. Autonomy 2. Justice 3. Nonmaleficence 4. Veracity
3. Nonmaleficence
Which medication is responsible for neonatal hypoglycemia? 1. Warfarin 2. Simvastatin 3. Tolbutamide 4. Methimazole
3. Tolbutamide Tolbutamide is an oral hypoglycemic agent used in the treatment of type 2 diabetes mellitus. It is known to have effects such as neonatal hypoglycemia. Warfarin, a common blood thinner, may cause teratogenic effects such as skeletal and central nervous system defects. Simvastatin, an HMG-CoA reductase inhibitor used for the treatment of high cholesterol, may cause teratogenic effects such as facial malformations and severe central nervous system anomalies. Methimazole, an antithyroid medication administered for the treatment of maternal hyperthyroidism, may cause teratogenic effects such as neonatal goiter, cretinism, and hypothyroidism.
A nurse manager is planning shift assignments with inadequate staffing. Based on the nurse's level of competence, which ethical approach principle will guide the manager's efforts? 1. Libertarianism 2. Egalitarianism 3. Utilitarianism 4. Patrialianism
3. Utilitarianism ------- 1. Libertarianism is a philosophy promoting the idea that some people are more valuable to society than others and need to be given the resources they require to survive. Staff assignments should be based on level of experience and patients' acuity. 2. Egalitarianism is the moral principle which focuses on the belief that all people should be equal. Staff assignments should be based on level of experience and patients' acuity. 3. Utilitarianism is the principle of distributing resources to produce the greatest good for the most people. Staff assignments should be based on level of experience and patients' acuity. 4. Patrialianism is not an approach to ethical principles.
During pregnancy, red blood cell (RBC) count may increase by _______%, and RBC volume may increase by _______% to _______%.
30%; 18% to 30%
At what gestational week do the following occur? Bones are fully developed Lungs are maturing. Increased amounts of adipose tissue are present.
32
Preterm labor (PTL) is defined as regular contractions of the uterus resulting in changes in the cervix before _______ weeks of gestation.
37
At what gestational week do the following occur? Fetus is considered fully matured and all organs and systems have developed.
38
Health care providers should wait until at least _______ weeks of pregnancy to induce labor or perform a cesarean delivery to prevent possible health problems.
39
A woman has opted to have a gamete intrafallopian transfer (GIFT) done. Which fertility condition in her history would indicate to the nurse that this is the correct procedure? 1. Unexplained infertility 2. Diminished sperm motility 3. Bilaterally blocked fallopian tubes 4. Failed infertility treatment for anovulation
4 1. Gamete intrafallopian transfer is a procedure used for unexplained infertility. 2. Artificial insemination is used when there is diminished sperm motility. 3. Embryo transfer is a procedure used for bilaterally blocked fallopian tubes. 4. Gamete intrafallopian transfer is a procedure used for failed infertility treatment for anovulation.
Providing encouragement to stop drinking alcohol to a prenatal client is an example of which ethical dilemma? 1. Non-maleficence 2. Fidelity 3. Veracity 4. Autonomy
4. Autonomy ------- 1. The obligation to do no harm is superseded by the client's right of autonomy. 2. Fidelity is being accountable for your responsibilities, which does not address this dilemma. 3. Veracity is being truthful, which does not address this dilemma. 4. Despite risks to the infant, the client has the right of autonomy.
A client complains to the nurse manager about the incompetent care she received from a nurse and threatens to sue the hospital. The nurse manager will anticipate which defensible nursing action against litigation? 1. Focus on Evidence-Based Practice care 2. Focus on competent care practices 3. Focus on routine facility protocols 4. Focus on the well-being of the patient
4. Focus on the well-being of the patient ------- 1. Evidence-Based Practice may not always translate to the "right" decisions for an individual patient. 2. Competent care is an integral part of the focus on the health and well-being of the patient. 3. Facility protocols are integral part of the focus on the health and well-being of the patient. 4. The only defensible nursing actions are those with sole focus on the health and well-being of the patient.
Which hormone levels do not require monitoring during the administration of menotropins for infertility? 1. Estrogen 2. Luteinizing hormone 3. Follicle-stimulating hormone 4. Gonadotropin-releasing hormone
4. Gonadotropin-releasing hormone Menotropins that are administered for infertility act at the pituitary level. Gonadotropin-releasing hormones act at the hypothalamic level; therefore this hormone does not need to be monitored. Menotropin is a standardized mixture of follicle-stimulating hormone and luteinizing hormone; these hormones should be monitored. Also, estrogen levels need to be monitored because the luteinizing hormone indirectly stimulates the production of estrogen.
Which is a complication that may develop in the child with hypospadias with chordee? 1. Renal failure 2. Testicular cancer 3. Testicular torsion 4. Sexual difficulties
4. Sexual difficulties Chordee can affect the child's future reproductive capabilities, which are related to the inability to inseminate directly. Kidney function is not affected by hypospadias with chordee. The incidence of testicular cancer is not increased; nor is the risk for testicular torsion.
The nurse is caring for a client who has been laboring for several hours. The client asks the nurse about the possibility and risks of cesarean delivery. Which ethical principle guides the nurse's response? 1. Beneficence 2. Nonmaleficence 3. Fidelity 4. Veracity
4. Veracity
Neonates with birth weights between _______ and _______ grams have the lowest mortality rate during the first year of life
4000 and 4999
While obstetric malpractice claims are only _____% of all claims, they represent _______% of a hospital's financial liability.
5%; 35%
What percent of women who are at risk for preterm delivery deliver at term? ------- What percent of women who deliver preterm have no risk factors?
70% ------- 50%
A cause can be identified in approximately _______% of couples who experience infertility. ------- Among identified causes of infertility, how many are related to female factors alone, male factors alone, or a both male and female factors at the same time?
80%; ------- Amongst the identified causes of infertility, each category splits evenly and is therefore responsible for a third of identified causes. That is to say: > Female factors alone are responsible for a third of identified causes of infertility > Male factors alone are responsible for a third of identified causes of infertility > Simultaneous Male and Female factors are responsible for a third of identified causes of infertility
About what percent of women experience nausea and vomiting during pregnancy (NVP)?
90%
What is the approximate temperature inside the scrotum?
96°F
What six changes take pace due the the increased production of estrogen and progesterone during pregnancy? [HI HUCS]
> Hypertrophy of uterine wall > Increased vascularity and hypertrophy of vaginal and cervical glands leads to increase in leukorrhea. > Hypertrophy of cervical glands leads to formation of mucus plug, which serves as a protective barrier between uterus/fetus and vagina > Uterus contractibility increases in response to increased estrogen levels, leading to Braxton-Hicks contractions. > Cessation of menstrual cycle (amenorrhea) and ovulation > Softening of vaginal muscle and connective tissue in preparation for expansion of tissue to accommodate passage of fetus through the birth canal
What three things should a woman be educated to avoid if she is planning on becomming pregnant?
> Illicit drugs, tobacco, and excessive caffeine intake > Environmental toxins > Medications contraindicated by pregnancy
What eight patient education topics should be included for women in the first trimester of pregnancy?
> Information on fetal development > Follow-up and reinforcement of nutrition > Information on physical changes during second trimester > Relief measures for typical discomforts > Warning and danger signs to be reported to provider > Signs and symptoms of preterm labor (PTL) > Signs and symptoms of hyptertensive disorders > Risks and benefits of procedures/tests to enable her to make informed decisions
What vitamins should be taken for pregnancy?
> Iron (though this one is controversial > Folic Acid (B9) > Calcium > Magnesium > Vitamin D
What are six treatments for male infertility and their indications? [L CHART]
> Lifestyle Changes to correct sperm count > Corticosteroids to decrease sperm antibodies > Hormonal therapies for endocrine disorders > Antibiotics to clear up genitourinary infections > Repair of variocele or inguinal hernia to facilitate sperm transport > Transurethral Resection of ejaculatory ducts to treat intercourse disorers
What complications may be present in neonates infected with the Zika virus?
> Microcephaly > Impaired growth > Impaired vision > Hearing defects
What are the 6 highest risk fators for male infertility? [O Shite]
> Older age > STIs > Heavy alcohol, cocaine, or marijuana use > Impotence > Tobacco (smoking) > Environmental pollutants
Female causative factors of infertility are broken down into three major categories. What are they?
> Ovulatory dysfunction (hormonal imbalances/high prolactin, hyper- or hypothyroidism, premature ovarian failure, PCOS (polycystic ovarian syndrome)) > Tubal and pelvic pathology (pelvic inflammatory disease, endometriosis, uterine fibroids) > Cervical mucus issues preventing sperm from reaching or surviving through the uturus (cervical infection, cervical surgery e.g. cryotherapy)
What are the four major hormones produced by the placenta, and what are their functions?
> Progesterone facilitates implantation and decreases uterine contractility. > Estrogen stimulates the enlargement of the breasts and uterus > human chorionic gonadotropin (hCG) stimulates the corpus luteum so that it will continue to secrete estrogen and progesterone until the placenta is mature enough to do so. This is the hormone assessed in pregnancy tests. hCG rises rapidly during the first trimester and then rapidly declines. > hPL promotes fetal growth by regulating available glucose and stimulates breast development in preparation for lactation.
What five changes to the breasts take place during pregnancy? [P'TIES
> Prominent veins due to 2x increase in bloodflow > Tenderness and tingling sensations > Increased blood supply > Enlargement of the breasts, nipples, areola, and Montgomery follicles > Striae (stretch marks)
What are six warning signs of preterm labor (PTL)?
> Rhythmic lower abdominal cramping or pain > Low backache > Pelvic pressure > Leaking of amniotic fluid > Increased vaginal discharge > Vaginal spotting or bleeding
What laboratory testing and diagnostics should be done during a preconception health care visit?
> Serum Blood Test for blood type and Rh factor, CBC, cholesterol, glucose, IgG Rubella, HIV, and syphilis > Urinalysis > STI cultures > Tuberculin skin test > Papanicolaou (Pap) Smear
What are three signs of hypertensive disorders during the second trimester?
> Severe headache that does not respond to relief measures > Visual changes > Facial or generalized edema
What are the components of the initial prenatal assessment? [SHOP AFL]
> Signs and symptoms of pregnancy > History of the current pregnancy > Obstetrical history > Physical and pelvic examinations > Assessment of uterine growth > Fetal heart tone assessment, if after 10-12 weeks' gestation > Laboratory and diagnostic studies
Oxytocin stimulates what two actons during pregnancy?
> Stimulates uterine contractions > Stimulates the milk ejection reflex in response to breastfeeding
From best to worst, state the six levels of evidence.
> Systematic Reviews and Meta-Analyses > Experimental designs (RCTs and pseudo-RCTs) > Quasi-Experimental designs (pre/post-test; retrospective studies) > Observational-analytic designs (cohort and case-controlled studies) > Observational-Descriptive designs (cross-sectional studies; case series/studies) > Background information and expert opinions
What abnormalities may be found while ausculating the hart of a woman mid-pregnancy?
> Systolic Heart Murmer > Gallup (third heart sound)
What food should a pregnant woman avoid? [T 3U 4R]
> Teas with chamomile, peppermint, licorice, or raspberry leaf > Unpasteurized juices or dairy products > Unpasteurized soft cheeses like Brie, Camembert, or feta > Unheated deli meats or hot dogs > Raw sprouts > Raw eggs > Raw fish and shellfish > Refrigerated, smoked seafood
What two membranes comprise the embryonic sac, and where do each originate from?
> The amniotic membrane forms the inner membrane and develops from the trophoblast > The chorionic membrane forms the outer membrane, and develops from the embryoblast
What are the two components of the pelvic exam perfrmed during the intial prenatal assessment?
> The bimanual exam, which involves internally palpating the uterus > Clinical pelvimetry (measurement of the dimensions of the bony pelvis through palpation during an internal pelvic examination)
What areas would be investigated via laproscopy in order to screen for potential cause of female infertility? [UFO]
> Uterus > Fallopian tubes > Ovaries
What are the seven components of a semen analysis? [V SWIMMM]
> Volume > Sperm concentration > White Blood Cell Count > Immunobead (anti-sperm antibodies) > Motility > Morphology > Mixed Agglutination Reaction Test
What three questions should be asked in order to screen for Intimate Partner Violence (IPV)?
> Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone? > Since you have been pregnant, have you been hit, slapped, kicked, or otherwise physically hurt by someone? > Within the last year, has anyone forced you to engage in sexual activities?
Since 1998, what three objective measures or findings have been most strongly linked the risk of spontaneous preterm births?
> cervical length > bacterial vaginosis > presence of fetal fibronectin in cervicovaginal fluid
What are the four major factors leading to preterm labor? [DIME]
> decidual hemorrhage > intrauterine infection > maternal or fetal stress > excessive uterine stretch or distension
During the initial prenatal labs, what three categories of patients should be screened for tuberculosis?
> recent immigrants from developing countries > inmates > residents of group homes.
Which STI can cause neonatal conjunctivitis? Select All. 1. Chlamydia 2. Gonorrhea 3. Syphilis 4. HIV
1 and 2: Chlamydia and Gonorrhea can cause neonatal conjunctivitis.
A nurse is attending the birth of a 22-week neonate. At delivery, there are no signs of life. Which are reasons for the healthcare team's decision to withhold treatment? Select all that apply. 1. Parental wishes 2. Ethical standards 3. Neonate prognosis 4. Hospital policy 5. Personal morals
1, 2, 3, 4 -------
What are the ranges (in weeks and days) for the following? 1. Early Term 2. Full Term 3. Late Term 4. Post Term ------- What simple tool may be used to demonstrate these ranges?
1. 37 weeks through 38 weeks, 6 days 2. 39 weeks through 40 weeks, 6 days 3. 41 weeks through 41 weeks, 6 days 4. 42 weeks and beond ------- The gestational wheel
Very low birth weight neonates account for _______% of all births and _______% of all infant deaths
1.45%; 54%
During pregnancy, the uterus's capacity increases from _______ mL to _______ mL— _______% of that to uteroplacental
10 mL; 5,000 mL; 80%
Periviable birth is delivery occurring from _______ weeks to fewer than _______ weeks of gestation
20; 26
At what gestational week do the following occur? Eyelids are open. Adipose tissue develops rapidly. The respiratory system has developed to a point where gas exchange is possible, but lungs are not fully mature.
28
How long, in days, is a typical pregnancy?
280 days (40 weeks)
The diaphragm may be displaced _______ cm during pregnancy.
4 cm
The ANA code of ethics applies to all nurses. Which is a function of the code of ethics? 1. To establish a moral standard for the profession 2. To hold nurses accountable for responsibilities 3. To distribute resources according to need 4. To be a resource for nurses facing ethical dilemma
4. To be a resource for nurses facing ethical dilemma
The amount of amniotic fluid peaks at _______ mL around _______ weeks' gestation and decreases to _______ mL at term.
800-1,000 mL; 34; 500-600 mL
The placenta becomes fully functional between which weeks of gestation? ------- By the 9th month, it measures between _______ and _______ cm in diameter, is _______ cm thick, and weighs approximately _______ grams.
8th to 10th ------- 15 and 25 cm; 3 cm; 600 g
What are eight warning/danger signs during the third trimester?
> Abdominal or pelvic pain (PTL, UTI, pyelonephritis, appendicitis) > Decreased or absent fetal movement (fetal hypoxia or death) > Prolonged nausea and vomiting (dehydration, hyperemesis gravidarum) > Fever, chills (infection) > Dysuria, frequency, urgency (UTI) > Vaginal bleeding (infection, friable cervix due to pregnancy changes or pathology, placenta previa, placenta abruptio, PTL) > Signs/symptoms of PTL > Signs/symptoms of hypertensive disorders
What are the common symptoms of the Zika virus?
> Conjunctivitis > Fever > Joint or Muscle Pain > Rash > Headache
What are the four primary functions of the amniotic fluid?
> Cushions the fetus from sudden maternal movements. > Prevents the developing human from adhering to the amniotic membranes. > Allows freedom of fetal movement, which aids in symmetrical musculoskeletal development. > Provides a consistent thermal environment.
During the third trimester, how often should a woman visit her medical provider?
> Every 2-3 weeks until week 36, then > Every week until week 40, then > Twice weekly from 40 weeks onward
What are the three parts of the uterus?
> Fundus > Body > Cervix
What is an Ebstein anomaly? ------- What medication may cause this if taken during pregnancy?
A critical congenital heart defect in which the septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart. ------- Lithium
What is Ophthalmia Neonatorum?
A neonatal infection caused when the infant is born to a mother who has a chlamydia infection.
What is an early symptom of cholestasis during pregnancy?
Abdominal pruritis
What do the seminal vesicles secrete?
Alkaline fluid with fructose, enzymes, and prostaglandins
What is leukorrhea?
An increase of vaginal discharge, common during pregnancy
What is a Doula?
An individual who provides support to women and their partners during labor, birth, and postpartum. The doula does not provide clinical care.
What organ produces prolactin?
Anterior pituitary
What are FSH and LH secreted by?
Anterior pituitary gland
From what week of pregnancy can fetal cardiac movement be noted via sonogram?
Beginning at 4 to 8 weeks
What does a Papanicolaou Smear primarily screen for?
Cervical cancer
The bluish coloration of the cervix, vaginal mucosa, and vulva is known as _______ sign. ------- When is this seen?
Chadwick's ------- At 6 to 8 weeks pregnancy
What is the expected response of a child under 2 years old to learning that they will have a new sibling?
Children younger than 2 are usually unaware of the pregnancy and do not understand explanations about the future arrival of the newborn
What is the most commonly reported STI?
Chlamydia
What are the two components of the fetal side of the placenta?
Chorionic membrane; Chorionic villi
What does the ductus venosus connect? ------- What is its function?
Connects the umbilical vein to the fetal inferior vena cava ------- Allows the majority of the highly oxygenated blood to enter the right atrium.
What hormone is responsible for amenorrhea during pregnancy?
Decreased FSH (follicle stimulating hormone) results in amenorrhrea during pregnancy.
What is the formula for Naegele's Rule?
EDD = First day of LMP - 3 monoths + 7 days EDD is the Estimated Date of Delivery LMP is the Last Menstrual Period
What germ layer is primarily responsible for the formation of the following? Epidermis Hair and nail follicles Sweat glands
Ectoderm
What germ layer is primarily responsible for the formation of the following? Lens and cornea Internal ear
Ectoderm
What germ layer is primarily responsible for the formation of the following? Mucosa of oral and nasal cavities Salivary glands
Ectoderm
What effects do progesterone and estrogen have on melatin production?
Estrogen and progesterone levels stimulate increased melanin deposition, causing light brown to dark brown pigmentation.
Cystic Fibrosis is the most common genetic disease of which ethnicity?
Europeans
Neural tube defects (NTDs) such as spina bifida has been reduced by as much as 50% due to the supplementation of what vitamin? ------- How much is recommended for a woman of childbearing age per day? ------- When is it most important to supplement this vitamin? ------- During pregnancy, how much should be taken by a woman with no previous NTDs? ------- During pregnancy, how much should be taken by a woman with a history of NTDs?
Folic Acid ------- 0.4 to 0.8 mg of Folic Acid (B9) per day, regardless of whether they plan on getting pregnant. ------- From 1 month before conception and through the first trimester (during neural tube formation) ------- 0.6 mg of Folic Acid ------- 4.0 mg of Folic Acid per day through the first trimester, and 0.4 mg per day for the remainder of the pregnancy.
What are the three primary hormones of spermatogenesis, from what are they secreted, and what are their functions?
Follicle-stimulating hormone (FSH): Secreted from the anterior pituitary gland, FSH stimulates sperm production; Luteinizing hormone (LH): Secreted from the anterior pituitary gland, stimulates testosterone production; Testosterone: Secreted by the testes, promotes sperm maturation
What is the first phase of the ovarian cycle called? ------- When does it begin? ------- How long does it last? ------- During this phase, the _______ follicle matures due to the hormones _______ and _______, and this mature follicle produces _______.
Follicular Phase ------- The first day of menstruation ------- 12 to 14 days ------- Graafian; LH and FSH; Estrogen
From what week of pregnancy can fetal heart sounds be auscultated?
From 10 to 20 weeks of pregnancy
What term refers generally to a group of pregnancy-related tumors that appear when cells in the womb start to proliferate uncontrollably? ------- What medicine might be used to treat a non-malignant variants?
Gestational Trophoblastic Disease ------- Dinoprostone
The softening of the cerivix is known as _______ sign. ------- When is this checked for?
Goodell's ------- At 8 weeks of pregnancy
What does Primigravida mean?
Gravida I, AKA a woman who is pregnant for the first time
What two specialists are able to diagnose a woman with infertility? ------- What specialist is able to diagnose a man with infertility? ------- If the initial treatments fail, what other specialist might a couple seek?
Gyneclogist or Reproductive Endocrinologist ------- Urologist ------- Obstetrist with specialty training in infertility
The sofenting of the lower uterine segment is known as _______ sign. ------- When is this checked for?
Heger's ------- At 6 weeks of pregnancy
During the initial prenatal labs, what test should be done to screen patients at risk for sickle cell traits?
Hemoglobin electrophoresis
What non-romantic relationship is key to determining how a woman will feel about her pregnancy?
Her relationship with her mother
What are the ranges in grams for High, Normal, Low, and Very Low birth weight?
High: Over 4000g Normal: 2500 to 3999g Low: 1500 to 2499g Very Low: Under 1500g
The Corpus Luteum is maintained during the first months of pregnancy due to what hormone?
Human Chorionic Gonadotropin (hCG)
What hormone matinains the Corpus Luteum during pregnancy until the placenta becomes fully functional?
Human Chorionic Gonadotropin (hCG)
What hormone is generally the cause of a positive pregnancy test? ------- How long after conception do these tests typically begin registering accurate results?
Human Chorionic Gonadotropin (hCG) ------- Four weeks after conception
Nausea and vomiting are commonly associated with the first trimester of pregnancy due to the effects of what hormone?
Human Chorionic Gonadotropin (hCG) causes changes to carbohydrate metabolism, which often causes nausea and vomiting during the first trimester.
What two hormones have the following functions? > Facilitate breast development > Alter carbohydrate, fat, and protein metabolism > Acts as an insulin antagonist > Facilitate fetal growth by altering maternal metabolism
Human Placental Lactogen (hPL) and Human Chorionic Somatomammotropin
Which sexually transmitted infection causes condylomata acuminate?
Human papillomavirus (HPV)
The changes to what organ results in heath intolerance during pregnancy?
Hyperplasia and increased vascularity of the thyroid may result in heat intolerance during pregancy.
Gingivitis, bleeding gums, and the increased risk of periodontal disease during pregnancy is commonly associated with the effects of what hormone?
Increased levels of estrogen lead to increased vascular congestion of mucosa
Increased risk of gallstone formation and cholestasis during pregnancy is commonly associated with the effects of what hormone?
Increased progesterone levels decrease muscle tone of gallbladder and result in prolonged emptying time
Bloating, flatulence, and constipation during pregnancy is commonly associated with the effects of what hormone?
Increased progesterone levels relax smooth muscle which slows the digestive process and movement of stool
Heartburn during pregnancy is commonly associated with the effects of what hormone?
Increased progesterone levels slow stomach emptying and relax the esophageal sphincter, resulting in the reflux of gastric contents into the lower esophagus (i.e. heartburn)
How long until a couple is deemed "infertile"? (There are TWO parts)
Infertility is the inability to conceive after: > 12 months for a woman under 35, or > 6 months for a woman 35 and over
What kind of anemia is commonly associated with pregnancy?
Iron Deficiency Anemia, due to the fetal need for iron
What is a Hysterosalpingogram (HPG)? ------- How is it performed? ------- What does it detect? [UT]
It is a radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. ------- Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus, and x-rays are taken of the area. ------- > Uterine abnormalities (fibroids, bicornate uterus, and uterine fistulas) > Tubal problems (adhesions or occlusions)
If pregnancy does not occur, what happens to the Corpus Luteum and what phase of the menstrual cycle is triggered? ------- If pregnancy occurs, what happens to the Corpus Luteum?
It undergoes Luteolysis and stops producing LH and estrogen; The menstrual phase ------- It continues to produce progesterone and estrogen until the placenta is able to take this task upon itself
What is melasma?
Melasma is a splotchy tan or dark skin discoloration which may result due to hormone changes during pregnancy (amongst other factors unrelated to pregnancy)
What kinds of fish should be avoided during pregnancy due to mercury levels?
Most long-lived or large predatory fish: > King mackerel > Orange roughy > Marlin > Shark > Swoardfish > Tilefish > Albicore
Preterm births account for approximately 70% of _______ deaths, 36% of _______ deaths as well as 25% to 50% of cases of long-term _______ impairment in children.
Neonatal; Infant; Neurologic
What is the term for a decreased production of amniotic fluid? ------- What kind of disorder may result within the newbors?
Oligohydramnios ------- Congenital renal problems
What is the second phase of the ovarian cycle called? ------- When does it begin? ------- How when does it end? ------- Which hormone surges immediately before ovulation, and when does this occur? ------- This surge is accompanied by a decrease and increase of which hormones?
Ovulatory phase ------- When estrogen levels peak ------- With ovulation ------- LH surges 12 to 36 hours before ovulation ------- Estrogen levels decrease and progesterone levels increases
What medication may be used to induce an abortion?
Oxytocin
What should happen if a pregnant woman is found to be Rh negative and the infant Rh postive?
Patients found to be Rh negative should be rescreened in the second trimester and given RhoGAM at 28 weeks and again after delivery.
What is the term for the excessive production of amniotic fluid? ------- What kind of disorders may result within the newbors (4)?
Polyhydramnios ------- chromosomal, gastrointestinal, cardiac, and neural tube disorders.
What is Preconception Care?
Preconception Care is a broad term that refers to the process of identifying social, behavioral, environmental, and biomedical risks to a woman's fertility and pregnancy outcome and reducing these risks through education, counseling, and appropriate intervention, when possible, before conception.
What is Quickening, and when does it occur?
Quickening is the moment during pregnancy when the woman is first able to feel the movements of the developing human, usually occuring around 18 to 20 weeks.
What is a myomectomy?
Surgical removal of uterine fibroids (leiomyomas)
During the initial prenatal labs, what three genetic conditions shlould be screened for in patients with Eastern European Jewish ancestry?
Tay-Sachs, Canavan, and familial dysautonomia
What might a fetal fibronectin test be used for?
Tests for preterm birth
By the end of pregnancy, what organ is situated high and to the right along the costal margin>
The Appendix
What is the CRL, and what is it used for?
The Crown-Rump Length; this is the method by which the length of the fetus is measured, from the crown of the head to the buttocks.
What produces amniotic fluid during the first trimester? ------- What produces amniotic fluid during the second and third trimesters?
The amniotic membrane ------- The fetal kidneys
What is the sperm's acrosome?
The anerior covering of the cell body which contains enzymes that allow the sperm to break through the zona pellucida and fertilize the ovum.
What is the endometrial cycle?
The changes in the endometrium of the uterus in response to the hormonal changes that occur during the ovarian cycle.
How is Maternal Death defined?
The death of a woman during pregnancy or within 42 days of pregnancy termination caused by conditions aggravated by the pregnancy or associated medical treatments, excluding accidents or injuries
During pregnancy, what may cause spasms of the round ligaments?
The distension of the uterus
What tissue composes the decidua post-fertilization? ------- What layers compose the decidua? ------- Which layer becomes the maternal side of the placenta?
The endometrium ------- decidua basalis, decidua capsularis, decidua vera ------- decidua basalis
During pregnancy, what hormone is responsible for facilitating uterine and breast development, increases in vascularity, and hyperpigmentation, as well as altering metabolic and electrolyte levels?
The increase in estrogen
Lordosis occurs during pregancy due to what physiological changes?
The pelvis tilts forward, changing the woman's center of gravity and affecting her posture and gait.
What is Ballottement? ------- When is it checked for?
The phenomenon by which a light tap of the examining finger on the cervix causes the fetus to rise in the amniotic fluid and then rebound to its original position. -------- 16 to 18 weeks
What is the only things that a positive sign of pregnancy can be attributed to? ------- What three methods are used to acheive this?
The presence of a fetus ------- > Sonographic visualization of the fetus > Observation and palpation by an examiner > Auscultation of fetal heart sounds
What is Anticipatory Guidance?
The provision of information and guidance to women and their families that enables them to be knowledgeable and prepared as the process of pregnancy and childbirth unfolds.
What is ovulation?
The release of the oocyte from the mature Graafian follicle
What is diastasis recti, and when does it usually occur?
The separation of the rectus abdominis muscle in the midline caused by the abdominal distention. It is a benign condition that can occur in the third trimester.
What is the function of the chorionic villi?
These project from the chorion and embed into the decidua basalis, which later forms the fetal blood vessels of the placenta
True or False: At 36 weeks of gestatioin, the uterus may expand to the xiphoid process
True
True or False: Depletion of maternal glucose stores leads to increased risk of maternal hypoglycemia during pregnancy.
True
True or False: Hypercoalulability occurs during pregnancy so the body can protect against the inevitable loss of blood during child birth.
True
True or False: Pregnancy leads to a decrease in peripheral vascular resistence, and this results in a lower blood pressure.
True
How often should women aged 21 -29 years have cytology screenings? ------- How often should women aged 30 - 65 years have HPV and cytology screenings?
Women aged 21 to 29 years should have cytology screening every 3 years. ------- Women aged 30 to 65 years should have human papillomavirus (HPV) and cytology co-screening every 5 years or cytology alone every 3 years.
What is the inheritance pattern of Duchenne's Muscular Dystrophy?
X-linked
What is a fertilized ovum called? ------- How many chromosomes does it have?
Zygote ------- 46 (diploid)
The search for a biological explanation for the pathways through which stress might affect preterm birth risk has led to extensive literature on the role of the hormone _______ as a potential mediator of this relationship.
corticotropin-releasing hormone (CRH)
How much iron is needed per day for a singleton pregnancy?
1 gram of iron per day
How many months old is an infant?
1 to 12 months old
Which statements indicate a phenotype? Select all that apply. 1. "The child has brown hair." 2. "Wow, he sounds exactly like his father." 3. "She has the most beautiful blue eyes." 4. "I carry the mutation in my genes for diabetes." 5. "He is short like his mother."
1, 2, 3, 5 1. Brown hair is an outward expression of a phenotype. 2. The sound of your voice is an outward expression of a phenotype. 3. Blue eyes are an outward expression of a phenotype. 4. Diabetes mutation genes are examples of genotypes. 5. Height is an example of a phenotype.
For a singleton pregnancy in each category, what is the total recommended weight gain and mean recommended weight gain per week during the second and third trimesters? 1. Underweight women 2. Normal weight women 3. Overweight women 4. Obese women
1. 28-40 lbs gained total, and 1 lb per week during the second and third trimesters 2. 25-35 lbs gained total, and 1 lb per week during the second and third trimesters 3. 15-25 lbs gained total, and 0.6 lbs per week during the second and third trimesters 4. 11-20 lbs gained total, and 0.5 per week during the second and third trimesters
Less than _______% of women with the clinical diagnosis of preterm labor actually give birth within 7 days of presentation.
10%
Basil metabolic rate (BMR) is raised by _______% to _______% by the third trimester of pregnancy.
10% to 20%
Very low birth weight neonates are _______ times more likely to die during the first year of life than are neonates with birth weights greater than 2,500 grams.
100
At what gestational week do the following occur? Fetal heart tone can be heard by Doppler device. Red blood cells are produced in the liver. Fusion of the palate is completed. External genitalia are developed to the point that sex of fetus can be noted with ultrasound. Eyelids are closed.
12
At what gestational week do the following occur? Lanugo is present on head. Meconium is formed in the intestines. Teeth begin to form. Sucking motions are made with the mouth. Skin is transparent.
16
How many cells make up the zygote 36 hours after fertilization? ------- How many cells make up the zygote 48 hours after?
2 ------- 4
Which hormone(s) may cause masculinization of a female fetus? Select all that apply. 1. Estrogen 2. Progesterone 3. Androgens 4. Diethylstilbestrol
2. Progesterone 3. Androgens
How long after fertilization does the fetal heart begin to beat?
3 weeks
During a ttransvaginal cervical ultrasonography, what cervical lengths greater than _______ reliably exclude risk of preterm labor in symptomatic individuals, while lengths less than ________ are strongly predictive of preterm labor risk.
30 mm; 20 mm
Which hormone may cause vaginal carcinoma in a female child after birth? 1. Estrogen 2. Progesterone 3. Androgens 4. Diethylstilbestrol
4. Diethylstilbestrol
Blood flow to the uterus is _______ to ________ mL per minute at term.
500 - 600 mL per minute
How long is a typical umbilical cord? ------- True or False: The umbilical cord is usually inserted in the center of the placenta.
55 cm ------- True
Chest circumference may increase by _______ cm, and the costal angle may increase by more than _______ degrees
6 cm; 90 degrees
Male causative factors of infertility are broken down into five major categories. What are they?
> Endocrine causes (pituitary or hypothalamic disorders; low LH, FSH, or testosterone) > Gonadotoxins (drugs, chemicals, illness, infection, radiation, overheated testes) > Sperm antibodies (usually resulting from trauma or reversed vasectomy) > Sperm transport issues (vasectomy, missing anatomy, prostatectomy, inguinal hernia, absence of vas deferens) > Intercourse disorders (erectile dysfunction, ejaculatory dysfunction, hypospadias, psychosocial factors e.g. depression)
What five hormones might be tested for a woman or man to determine an endocrine cause of infertility? [FLATT]
> FSH (follicle stimulating hormone) > LH (luteal hormone) > AMH (anti-Muellerian hormone) > Testosterone > TSH (thyroid stimulating hormone)
What weeks make up the first, second, and third trimesters of pregnancy?
> First trimester: First day of LMP through 14 completed weeks > Second trimester: 15 weeks through 28 completed weeks > Third trimester: 29 weeks through 40 completed weeks
What are the components of the GTPALM assessment?
> G is for Gravida (total number of pregnancies) > T is for number of term infants (38-42 weeks' gestation) > P is for Preterm Births (20-38 weeks' gestation) > A is for Abortions before 20 weeks > L is for the number of children currently living > M is for the total number of multiple gestations
What are the six most common assites fertility technologies? [GAZE IT]
> Gamete intrafallopian transfer (GIFT) > Artificial Insemination (AI) > Zygote Intrafallopian Transfer (ZIFT) > Embryo transfer (ET) > In vitro fertilization (IVF) > Testicular Sperm Aspiration (TESA)
What are the four most common risk factors for preterm births?
> Prior preterm birth (single most important factor reoccurrence rates of up to 40%) > Multiple gestation (50% of twins delivered preterm, ≥90% higher multiples delivered preterm) > Uterine/cervical abnormalities > diethylstilbestrol (DES) exposure
What three changes take pace due the the increased production of prolactin during pregnancy? [PII]
> Production of colostrum > Increased growth of mammary glands > Increase in lactiferous ducts and alveolar system
What are three priority vaccinations for a woman who wishes to become pregnant?
> Rubella > Flu > Hepatitis C
What is Pica? ------- What dangers are associated with it?
A craving for and consumption of non-food items such as starch and clay. ------- Pica may result in toxicity due to the potentially harmful contents of the target substances and their displacement of more nutritious foods.
What risk factor is the most reliable in assessing whether a woman may deliver preterm?
A history of preterm births, especially of multiple occurances. Women with one prior preterm delivery before 35 weeks have a 16% recurrence risk, those with two early preterm deliveries have a 41% risk, and those with three prior preterm deliveries have a 67% risk of subsequent preterm birth before 35 weeks
What is a choriocarcinoma? ------- What is the prognosis?
A malignant, trophoblastic, germ cell cancer, usually of the placenta, though very rarely it may occur in the testicles in men and the ovaries in women. ------- For women, it is highly sensitive to chemotherapy and the cure rate is 90+%. For men, it is the most aggressive germ cell cancer of adults, is highly resistant to chemotherapy, and prognosis is very poor.
During the pregnancy, the pH of the vagina becomes more acidic or alkaline? ------- What infection is more likely to occur due to this change in pH?
Acidic ------- Candidiasis (aka yeast infection due to Candida albicans)
From what week of pregnancy can an examiner observe and palpate fetal movement?
After 20 weeks of pregnancy
What is urinary stasis? ------- What is a common complication?
Also called urinary retention, it is the inability to completely empty the bladder. ------- UTIs
What is Couvade Syndrome?
Also known as sympathetic pregnancy, it is the phenomenon by which men experience pregnancy-like symptoms and discomforts similar to those of their pregnant partner, such as nausea, weight gain, or abdominal pains
What is BBT used for? ------- How is it performed?
Basal Body Temperature (BBT) charting is performed to identify when a woman ovulates and thereby has her best chance to conceive. ------- The woman takes her temperature each morning before rising using a basal thermometer, and charts the results. Ovulation has occurred if there is a rise of 0.4°F for 3 consecutive days.
What is a normal Fetal Heart Rate (FHR)?
Between 110 to 160 beats per minute.
Around the fifth day post-fertilization, the developing human enters the uterus and becomes a _______.
Blastocyst
What laboratory test checks for possible isoimmunization? ------- At what two times should this test be done? ------- What medication should be given if the test is positive? ------- At what two times should this medication be given?
Blood type and Rh factor with antibody screening ------- First as a part of the initial prenatal labs, and again during the second trimester ------- RhoGAM ------- At 28 weeks; after delivery if the infant is RH positive.
What two ligaments hold the ovaries in place?
Broad ligament and ovarian ligament
How is uterine growth measured after 10-12 weeks' gestation? ------- How is it performed? ------- What is the expected result?
By measuring the height of the fundus with the use of a centimeter measuring tape. The zero point of the tape is placed on the symphysis pubis, and the tape is then extended to the top of the fundus. ------- The zero point of the tape is placed on the symphysis pubis, and the tape is then extended to the top of the fundus ------- The result in centimeters should approximately equal the week of gestation (e.g. about 20 cm is expected at 20 weeks')
What drug would be perscribed to a woman experiencing anovulatory infertility? ------- How does it work? ------- What side effect should be covered during education? ------- When is it taken? ------- True or False: Common side effects include headaches, breast tenderness, and vaginal dryness.
Clomid (clomiphene) ------- Clomiphene stimulates the release of FSH and LH, which in turn stimulate ovulation ------- Do not drive if the patient experiences blurry vision ------- From days 3-7 of the woman's menstrual cycle ------- True
What are cotyledons?
Cotyledons are the divisions/compartments of the maternal side of the placenta.
What germ layer is primarily responsible for the formation of the following? Nervous system Pituitary gland Adrenal medulla
Ectoderm
What are the three germ layers of the developing embryo?
Ectoderm (outer layer), Mesoderm (middle layer), and Endoderm (inner layer).
What germ layer is primarily responsible for the formation of the following? Epithelium of respiratory tract, including lungs
Endoderm
What germ layer is primarily responsible for the formation of the following? Liver Mucosa of gallbladder
Endoderm
What germ layer is primarily responsible for the formation of the following? Mucosa of esophagus, stomach, and intestines
Endoderm
What germ layer is primarily responsible for the formation of the following? Thyroid gland Pancreas
Endoderm
What is the inner lining of the uterus called? ------- What are its two layers called? ------- Which layer is shed during menstruation? ------- What two hormones influence the growth of this layer?
Endometrium ------- basilar layer and functional layer ------- functional layer ------- Estrogen and progesterone
What is the coiled, tube-like structure on the posterior surface of the testes called? ------- What sections is it divided into? ------- What takes place within them?
Epididymis ------- Head, body, and tail ------- Maturation of sperm cells
During the first trimester, how often should a woman visit her medical provider?
Every four weeks
During the second trimester, how often should a woman visit her medical provider?
Every four weeks
What is ptyalism?
Excessive salivation, often seen in pregnancy
Relating to oogenesis, what hormone stimulates growth of the ovarian follicles and stimulates the follicles to secrete estrogen? ------- What hormone promotes the maturation of the ovum?
FSH ------- Estrogen
Oogenisis is regulated by two primary hormones. What are they, and from what are they secreted?
FSH from the anterior pituitary gland; Estrogen from the follicle cells
In the first step of oogenesis, the hormone _______ stimulates the growth of the _______ , which contains a(n) ________. ------- What process takes place next, and what are the results? ------- What process takes place next, and what are the results?
FSH; ovarian follicle; oogonium (stem cell) ------- Mitosis; two daughter cells: a new stem cell, and a primary oocyte ------- Meiosis; one polar body which then divides into two, and a secondary oocyte which divides into a third polar body and a mature ovum.
Where does fertilization take place?
Fallopian tubes, typically a third of the way from the ovary to the uterus.
True or False: Tetracycline and Doxycycline are safe to take during pregnancy.
False
What are Braxton-Hicks contractions?
False labor: contractions that
True or False: Alpha Fetal Protein (AFP) screening is is an acceptible strategy for identifying chromosome abnormalities and neural tube defects (NTDs)
False: AFP screening is only acceptible for screening NTDs.
True or False: The increase of red blood cells is relatively larger than the increase in plasma, resulting in polycythemia.
False: Hemodilution occurs, caused by the increase in plasma volume being relatively larger than the increase in RBCs, which results in decreased hemoglobin and hematocrit values
True or false: Only one semen analysis is necessary in order to screen for potential causes of infertility.
False: Many may be required due because sperm production normally fluctuates.
Monozygotic twins are also known as _______, and dizygotic twins are also known as _______.
Identical twins; Fraternal twins
What are the ranges (in weeks) for Late Premature, Moderately Premature, Very Premature, and Nonviable?
Late Premature: 34 - 36 weeks Moderately Premature: 32 - 34 weeks Very Premature: 21 - 32 weeks Nonviable: 20 weeks and under
What is linea nigra?
Linea nigra is a dark vertical line that runs vertically along the midline of the abdomen from the pubis to the umbilicus, but can also run from the pubis to the top of the abdomen. It appears in about three quarters of all pregnancies.
Fetal fibronectin has a (high or low?) positive predictive value and a (high or low?) negative predictive value.
Low positive predictive value; high negative predictive value thereby making it a useful test to predict those women who will NOT deliver preterm.
What is the third stage of the ovarian cycle called? ------- When does it begin? ------- About how long (in days) does it last, and what event marks the end of this phase? ------- What does the empty follicle in the ovary become during this phase?
Luteal Phase ------- After ovulation ------- 14 days; Menstruation ------- Corpus Luteum
What medication may be used during tocolytic therapy for fetal neuroprotection?
Magnesium Sulfate
What is the third phase of the endometrial cycle called? ------- When does it begin? ------- When does it end? ------- What hormonal changes occur during this phase?
Menstrual phase ------- ------- When the functional layer has been shed ------- Progesterone and Estrogen levels fall as a result of luteolysis, and FSH and LH rise.
What germ layer is primarily responsible for the formation of the following? Bone marrow and blood Lymphatic tissue Lining of blood vessels
Mesoderm
What germ layer is primarily responsible for the formation of the following? Dermis Bone Cartilage
Mesoderm
What germ layer is primarily responsible for the formation of the following? Kidneys Adrenal cortex
Mesoderm
What germ layer is primarily responsible for the formation of the following? Skeletal muscles Cardiac muscles Most smooth muscles
Mesoderm
What does the prostate secrete?
Milky, slightly acid fluid (note: this textbook (Maternal Newborn Nursing, isbn: 978-0803666542) is the only resource I've seen that says alkaline fluid?)
Cerebral palsy, hearing and vision impairment, and chronic lung disease are long-term sequelae associated with _______.
Preterm birth
What may result due to either uteroplacental vascular insufficiency, exaggerated inflammatory response, hormonal factors, cervical insufficiency, or genetic predisposition?
Preterm labor
What effect does progesterone have on smooth muscle?
Progesterone relaxes smooth muscle
The Corpus Luteum releases high levels of _______ as well as some _______.
Progesterone; Estrogen
What hormon facilitates lactation?
Prolactin
What is the first phase of the endometrial cycle called? ------- When does it begin? ------- When does it end? ------- What triggers this phase? ------- What takes place during this phase?
Proliferative phase ------- At the end of menstruation ------- With ovulation ------- Increasing levels of estrogen from the Graafian follicle ------- The functional layer of the endometrium prepares for implantation by becoming thicker and more vascular.
The "Back to Sleep" campaign seeks to reduce the instance of _______.
SIDS (sudden infant death syndrome)
What is the second phase of the endometrial cycle called? ------- When does it begin? ------- When does it end? ------- What is the primary hormone of this phase, and where is it secreted from? ------- What takes place during this phase if pregnancy does not occur? ------- What takes place during this phase if pregnancy occurs?
Secretory phase ------- After ovulation ------- The onset of menstruation or implantation of the blastocyst ------- Progesterone secreted by the Corpus Luteum ------- The functional layer continues to thicken until the Corpus Luteum degrades, at which point the functional layer also begins to degrade. ------- The functional layer continues to develop and begins to secrete glycogen for the blastocyst
Spermatogenesis takes place in the _______, and from there they travel through the _______, then the _______, and finally the _______.
Seminiferous tubules; Rete testis; Epididymis; Vas deferens, aka ductus deferens
What is the function of the placental membrane?
Separates the maternal and fetal blood, while allowing for the exchange of gases, nutrients, and electrolytes.
How long will it take for a woman to be able to conceive if she has been using Depo-Provera for a contraceptive?
Several months to over a year
How long should she wait before attempting to conceive if she has been on contraceptive therapies?
She should have two to three normal menstrual cycles before attmepting to conceive.
What are the three categories of preterm labor and preterm birth?
Spontaneous, medically indicated, and non-medically indicated (elective)
What are the two parts of a blastocyst, and what are their functions?
The inner cell mass is the Embryoblast, and this develops into the embryo; The outer cell mass is the Trophoblast, and this assists in implantation and will become a part of the placenta.
What does foramen ovale the connect? ------- What is its function? ------- When does this close?
The left and right atria ------- Allows oxygenated blood to flow directly from the right atrium to the left atrium. ------- Within three months of birth
What position is best to reduce cardiovascular, lymphatic, and renal symptoms of a pregnant woman?
The left lateral recumbent maternal position can: ● Maximize cardiac output, renal plasma volume, and urine output. ● Stabilize fluid and electrolyte balance. ● Minimize dependent edema. ● Maintain optimal blood pressure.
How is the gestational age defined? ------- How is fetal age defined?
The number of completed weeks from the first day of the last menstrual period (LMP) ------- The number of completed weeks about two weeks before the first day of the LMP.
After delivery, what should the nurse assess and document in the umbilical cord and why?
The number of vessels in the cord. Newborns with only two vessels (one artery and one vein) have a 20% chance of having a cardiac or vascular defect.
From the stem cell to the mature sperm cells, what is the process of spermatogenesis?
The stem cell undergoes mitosis to form one new stem cell and one spermatogonium which then differentiates into a primary spermatocyte. Then, the first meiotic division takes place, resulting in two secondary spermatocytes. These then undergo a second meiotic division which results in four spermatids, which then mature into four mature spermatozoa.
What is the typical span (in weeks) that a woman is expected to give birth based on the Estimated Date of Delivery (EDD)?
The woman is expected to give birth from 3 weeks before to two weeks after the EDD
What is the expected response of a 6-12 years old to learning that they will have a new sibling?
They are usually enthusiastic and keenly interested in the details of pregnancy and birth. They have many questions and are eager to learn. They often plan elaborate welcomes for the newborn and want to be able to help when their new sibling comes home.
How might uterine fibroids cause a spontaneous abortion
They may narrow the uterine cavity to an extent which interferes with embryonic or fetal development, thus leading to a spontaneous abortion.
What is the expected response of a 4-5 years old to learning that they will have a new sibling?
They often enjoy listening to the fetal heartbeat and may show interest in the development of the fetus. As pregnancy progresses, they may resent the changes in their mother's body that interfere with her ability to lift and hold them or engage in physical play.
During which trimester does a woman's ambivilance to pregnancy become concerning? ------- What might this indicate? ------- What should be assessed?
Third trimester ------- Unresolved conflict ------- Assess the reasons for the ambivilance and its intensity
What is the role of the CenteringPregnancy program?
To provide between 12 and 20 hours of antenatal care in a group setting for pregnant women in order to promote individual responsibility for health in pregnancy; provide appropriate prenatal assessment and risk screening; and provide education, social support, and a sense of community, all in a cost-effective and efficient manner.
True or False: Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization.
True
True or False: Under federal law, nurses have the right to refuse to assist in the performance of any health care procedure in keeping with personal moral, ethical, or religious beliefs
True
True or False: Zika can be transmitted via sexual intercourse even if symptoms are not present.
True
True or False: a woman is at an increased risk of UTI during pregnancy.
True
True or false: LGBT women are more likely to smoke cigarettes, drink heavily, and be obese than heterosexual women
True
What primary blood vessels does the umbilical cord contain? ------- Which vessels carry oxegenated blood? ------- What is the collagenous substance that surrounds these vessels, and what is its function?
Two umbilical arteries and one umbilical vein ------- The umbilical vein ------- Wharton's jelly; protects the vessels from compression
High levels of oxygenated blood enter the fetal circulatory system from the placenta via the _______.
Umbilical vein
What should caffeine be limited to during pregnancy?
Under 200 mg per day
During the initial prenatal labs, what two diseases should the mother be screened for in order to determine if she is suceptible or immune to them?
Varicella and rubella
What is Shoulder Dystocia? ------- What are two common complications that may result in the neonate?
When a neonate's shoulder is caught above the mother's pubic bone after the neonates head has emerged from the vagina. ------- Brachial plexus injury; clavicle fracture
What is supine hypotensive syndome?
When a pregnant woman lies supine, the enlarged uterus compresses the inferior vena cava, causing reduced blood flow back to the right atrium and a drop in cardiac output and blood pressure.
Death before birth at less than 20 weeks gestation is called a _______, and death after 20 weeks but before birth is called a _______.
miscarriage; stillbirth
Generally, how long does it take for a woman to realize that she is pregnant?
one to two weeks
Increased progesterone and relaxin levels lead to _______ of joints and _______ joint mobility, resulting in _______ and _______ mobility of the sacroiliac and symphysis pubis.
softening; increased; widening; increased;
By the third day after fertilization, the _______ has morphed into a solid sphere of _______ (how many?) cells and is called a _______.
zygote; 16; morula
True or False: The satisfaction and efficacy of group-centered pregnancy education is higher than one-on-one physician-centered care.
False: One-on-one and group education have been found to be equally effective and satisfactory to their respective participants.
True or False: Huntington's disease, familial hypercholesterolemia, and xeroderma pigmentation are all Autosomal-Recessive diseases.
False: These are all Autosomal-Dominant diseases.
True or False: Insulin production is decreased during pregnancy.
False: insulin production is increased during pregnancy.
True or False: Most organs are composed of tissue originating from a single germ layer.
False: most organs are composed of combinations of tissues from multiple germ layers.
True or False: A woman should not exercise during pregnancy.
False: though an exercise program should be started at least one month prior to pregnancy, weight bearing and aerobic exercises are both beneficial to the pregnant woman's health.
During which trimesters would fatigue be expected?
First and third
The nurse administers intravenous magnesium sulfate to a client admitted with severe preeclampsia. The nurse identifies which as the classification of this medication? 1. Diuretic 2. Oxytocic 3. Antihypertensive agent 4. Central nervous system depressant
Magnesium sulfate is a central nervous system depressant; it eases cerebral irritability, thus preventing seizures. Magnesium sulfate is not a diuretic; however, adequate kidney function is necessary to promote its excretion. Otherwise, toxicity will result. Magnesium sulfate is not an oxytocic; oxytocin is used to promote uterine contractions and can cause an increased blood pressure. Magnesium sulfate is not an antihypertensive; however, it may cause a transient decrease in blood pressure because of its peripheral dilating effect.
What is the expected response of a 2-4 years old to learning that they will have a new sibling? ------- What should the parents focus on addressing for these children?
They may respond to the obvious changes in their mother's body, but may not remember from month to month why the changes are occurring. ------- This age group is particularly sensitive to the disruptions of the physical environment. Therefore, if the parents plan to change the sibling's sleeping arrangements to accommodate the new baby, these arrangements should be implemented well in advance (2+ months) before birth.
Why might an endometrial biopsy be performed? ------- When during the menstrual cycle is it performed? ------- True or False: An endometrial biopsy may be performed in a medical office.
To assess the response of the uterus to hormonal signals that occur during the cycle. ------- The biopsy is performed at the end of the menstrual cycle ------- True
What effect does cortisol have regarding resistance to insulin during pregnancy?
> Cortisol incrreases maternal resistance to insulin, which may result in hyperglycemia and Type II Diabetes Mellitus.
What four methods might be used to screen for ovulatory dysfunction? [DOOB]
> Detection of an LH surge > Ovulatory Prediction Kits > Ovarian Reserve Testing > BBT (Basal Body Temperature)
What three symptoms may occur due to compression of the inferior vena cava and iliac veins during pregnancy?
> Edema of lower extremeties > Varicositeis of legs and vulva > Hemmerhoids
Broadly speaking, what four patient education topics should be included for women in the first trimester of pregnancy?
> General information about physical changes > General information about fetal development > General health maintenence and promotion > Warning and danger signs to be reported to provider
What are the five primary nursing goals of prenatal care? [BROMA]
> Build rapport with the family > Refer to appropriate resources > Ongoing assessments of risk factors and implementation of appropriate interventions > Maintenence of maternal and fetal health > Accurate determination of fetal age
The nurse is providing a client with education about teratogens at her first prenatal appointment at 8 weeks. The nurse knows that education has been successful when the client makes which statement? 1. "I will have my partner change the cat's litter box from now on." 2. "I cannot eat chicken for the risk of toxoplasmosis." 3. "I should only report prescription medications; herbal supplements are safe." 4. "I do not have to worry about teratogens until my second trimester, when the baby is fully formed."
1 1. Toxoplasma is a parasite found in cat feces that is considered a teratogen and should be avoided by pregnant women. 2. Toxoplasmosis is a teratogen found in uncooked beef or lamb; campylobacter is found in uncooked chicken. 3. The client should report all prescription and over-the-counter medications, as well as vitamins and herbal supplements. 4. The fetus is most vulnerable to the effects of teratogens during the first 8 weeks of pregnancy. In the second trimester, the fetus can develop growth restrictions due to teratogen exposure.
What three classes of medications are common tocolytic agents?
> Calcium Channel Blockers e.g. Nifedipine (often with -pine suffix) > NSAIDs e.g.Indomethacin > Beta-Adregernic Receptor Agonists e.g. Terbutaline (often with -ine suffix)
Which assessment findings would a nurse report to the health care provider for early diagnosis and interventions of fetal alcohol syndrome? Select all that apply. 1. Lack of focus 2. Small head 3. Poor coordination 4. Hypoactivity 5. Facial deformity
1, 2, 3, and 5 ------- Option 1: Lack of focus is a brain and central nervous system problem in newborns with FAS. Option 2: A small head is a physical defect in newborns with FAS. Option 3: Poor coordination is a brain and central nervous system problem in newborns with FAS. Option 4: Hyperactivity, not hypoactivity, is a brain and central nervous system problem in newborns with FAS. Option 5: Facial deformity is a physical defect in newborns with FAS.
A couple visited the clinic and wanted to know their likelihood of conceiving a child with a genetic disorder. Which risk factor, identified by the nurse, is correct? Select all that apply. 1. Their first child was born with a genetic disorder. 2. There is a family history of genetic disorders. 3. Both partners are younger than 35 years old. 4. The woman is older than 35 years old. 5. Both parents have a genetic disorder.
1, 2, 4, 5 1. A previous pregnancy that resulted in a genetic disorder puts the couple at risk of having a baby with a genetic disorder. 2. Family history of genetic disorder passes on the genes to the parents. 3. Being younger than 35 years old minimizes the risk of having a child with a genetic disorder. 4. Women who are older than 35 years old are at a greater risk of having a baby with a genetic disorder. 5. If both parents have a genetic disorder, there is a greater risk of conceiving a child with a genetic disorder.
Ethical issues arise when clients use assisted reproductive therapies. Which are ethical issues? Select all that apply. 1. Who owns the embryos? 2. Do sperm donor have rights? 3. The surrogate mother funds her own treatment. 4. Who decides what happens with the surplus embryos? 5. Should the surrogate mother do skin-to-skin with the infant after birth?
1, 2, 4, 5 1. This is an ethical question. 2. This is an ethical question. 3. This isn't an ethical question. When a client hires a surrogate, the client pays for the surrogate's medical care for having the child. 4. This is an ethical question. 5. This is an ethical question.
Which of the following risks are increased in an obese pregnant client? Select all that apply. 1. Gestational diabetes 2. Preeclampsia 3. Abruptio placenta 4. Sleep apnea 5. Precipitous delivery
1, 2, and 4 Option 1: Gestational diabetes is associated with maternal obesity, but usually resolves after delivery. Option 2: Preeclampsia is associated with maternal obesity and may advance to eclampsia. Option 3: Abruptio placenta is not associated with maternal obesity. Option 4: Sleep apnea is associated with obesity and worsens with pregnancy Option 5: Obese women are more likely to have prolonged labor.
Which scenarios listed below exemplify errors in clinical judgement? Select all that apply. 1. Failure to recognize deteriorating fetal status 2. Failure to check for imminence of delivery 3. Failure to have client sign admission paperwork 4. Failure to therapeutically communicate with client 5. Failure to communicate status of client to provider
1, 2, and 5 ------- Option 1: Failure to recognize deteriorating fetal status constitutes an error in clinical judgement. Option 2: Failure to check for imminence of delivery constitutes an error in clinical judgement. Option 3: Failure to have the client sign admission paperwork constitutes an administrative failure. Option 4: Failure to therapeutically communicate with the client constitutes miscommunication. Option 5: Failure to communicate status of the client to the provider constitutes an error in clinical judgement.
Which is an appropriate assistance the nurse can provide to the couple who found out during pregnancy that their child has a genetic disorder? Select all that apply. 1. Provide credible websites containing information specifically about the genetic disorder. 2. Leave them be. They have time to learn about it later on in the pregnancy or when the child is born. 3. Encourage them to communicate with one another. 4. Find a support group for the couple. 5. Ask the couple closed-ended questions.
1, 3, 4 1. When a client starts to search the Internet, they come across inaccurate information. 2. Though this is a case of always learning more, this should not be what the nurse does. Giving clients the most information up front and at diagnosis can help them begin the process of understanding. 3. Many couples have a hard time communicating when they don\"t have the "dream" child. It's important be a team in this because it can lead to stress on both parents. 4. Finding a support group can help when the parents are feeling alone. Encourage them to go and share their situation with others who are going through it. 5. Asking closed-ended questions that require only a "yes" or "no" response will not help with discovering the couple's needs.
The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. 1. "Progesterone is the hormone that makes you feel bloated." 2. "Testosterone is produced only if you are having a boy." 3. "Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4. "Human placental lactogen helps in the production of breast milk." 5. "Estrogen is the reason for my pregnancy glow."
1, 3, 4, 5 1. This hormone is produced by the placenta. 2. This hormone is not produced by the placenta. 3. This hormone is produced by the placenta. 4. This hormone is produced by the placenta. 5. The estrogen hormone is produced by the placenta.
Cardiovascular changes during pregnancy include: 1. a blood volume increase of _______% to _______% 2. cardiac output increase of _______% 3. stroke volume icrease of _______% to _______% 4. heart rate increase of _______ to _______ beats per minute
1. 40% to 45% 2. 40% 3. 15 to 20 beats per minute 4. 25% to 30%
What are the three phases which father's experience as pregnancy progresses?
1. Announcement phase: lasts 2. Moratorium phase 3. Focusing phase
Which antihypertensive medication is contraindicated in lactating women? 1. Atenolol 2. Labetalol 3. Metoprolol 4. Propranolol
1. Atenolol Atenolol is contraindicated in lactating woman because it enters the breast milk and may cause adverse effects to the neonate. Labetalol and propranolol are safe to administer during lactation. Metoprolol is considered a safe medication to be taken during lactation.
The nurse is working at a facility that promotes breastfeeding. Supporting a patient's free choice and personal decisions to bottle-feed is guided by which ethical principle? 1. Autonomy 2. Fidelity 3. Justice 4. Veracity
1. Autonomy
Which STI can lead to pneumonia in a neonate? 1. Chlamydia 2. Gonorrhea 3. Syphilis 4. HIV
1. Chlamydial pneumonia is a complication of Chalmydia
A past trend of maternal newborn nursing is a hospital post-partum stay of 10 days. Which issue did this put the client at risk for? 1. Deep vein thrombosis (DVT) 2. Pulmonary hypertension 3. Impaired skin integrity 4. Post-partum infection
1. Deep vein thrombosis (DVT)
A nurse is explaining Body Mass Index (BMI) to clients at a preconception class. Which BMI selected by a client as normal for optimal conception indicates that learning has occurred? 1. Less than 18.5 2. 18.5 to 24.9 3. 25 to 29.9 4. More than 30
2. 18.5 to 24.9 (AKA normal BMI)
The fetal heart rate (FHR) tracing records 90 beats per minute without absent baseline variability. Which FHR classification will the nurse interpret for this tracing? 1. Category I (normal) 2. Category II (indeterminate) 3. Category III (abnormal) 4. Category IV (subnormal)
2. Category II (indeterminate) ------- 1. Category I is normal and includes moderate FHR variability and heart rate between 110-160 bpm. This option is incorrect based on the bradycardia. 2. Category II is indeterminate and includes all FHR tracings not categorized as Category I or Category III. 3. Category III is abnormal and includes absent baseline FHR variability. This option is incorrect based on absent variability in the question. 4. There is no category IV FHR classification.
What is the leading cause of infant death in the USA? 1. Disorders related to short gestation and low birth weight 2. Congenital malformations and chromosomal abnormalities 3. Newborn affected by maternal complications of pregnancy 4. Newborns affected by complications of placenta, cord, and membranes
2. Congenital malformations and chromosomal abnormalities ------- 1. Disorders related to short gestation and low birth weight were the number 2 cause of infant death in 2015. 2. Congenital malformations and chromosomal abnormalities were the leading cause of infant death in 2015. 3. Maternal complications were the number 5 cause of infant death. 4. Complications of placenta, cord, and membranes were the number 6 cause of infant death.
The husband of a laboring client is insisting on a cesarean birth. The primary advocacy role of the nurse will be for which client? 1. Father 2. Mother 3. Fetus 4. Family
2. Mother ------- 1. Practice dictates the primary advocacy role of maternity nurses is on behalf of the mother. 2. A competent client can make decisions regarding her care. Maternity nurses may not agree with the mother's choices but their duty to respect her autonomy will help guide their care 3. Obligations to the fetus are tempered by the context of the mother's decisions. 4. Practice dictates the primary advocacy role of maternity nurses is on behalf of the mother.
Which medication is used to prevent preterm labor? 1. Oxytocin 2. Nifedipine 3. Raloxifene 4. Clomiphene
2. Nifedipine Nifedipine is used to prevent preterm labor because it inhibits myometrial activity by blocking the influx of calcium. Oxytocin may be used to induce labor. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used to cause ovulation.
Which risk factor contributes the most to the low birth weight? 1. Teen pregnancy 2. Smoking tobacco 3. Using illicit drugs 4. Obesity
2. Smoking tobacco ------- Option 1: Teen mothers are at increased risk for low birth weight neonates, but smoking causes LBW. Option 2: Nicotine is toxic to developing fetuses and causes LBW. Option 3: Illicit drug used during pregnancy is not associated with LBW. Option 4: Obesity is not associated with LBW.
Which intervention would the nurse recommend for post-cesarean gas pain? 1. Lying on the right side 2. Walking around the room 3. Using a straw when drinking water 4. Supporting the incision when moving
2. Walking around the room Walking around as much as possible can help expel excess gas after a cesarean birth. The client also may be advised to lie on the left (not right) side and rock in a rocking chair. The client should avoid using a straw when drinking water or other fluids. Supporting the incision when moving relieves incisional pain, but does not promote expulsion of gas.
At what gestational week do the following occur? Lanugo covers the entire body. Vernix caseosa covers the body. Nails are formed. Brown fat begins to develop
20
Preterm birth (PTB) is defined as birth from _______ weeks of gestation and to fewer than _______ weeks of gestation.
20; 37
At what gestational week do the following occur? Eyes are developed. Alveoli form in the lungs and begin to produce surfactant. Footprints and fingerprints are forming. Respiratory movement can be detected.
24
What are the five categories of midwives?
> Certified Nurse Midwife > Certified Midwife > Certified Professional Midwife > Direct Entry / Lay / Licensed Midwife (state licensed) > Direct Entry / Lay Midwife (unlicensed)
What are AWHONN's core values (remember "CARING")?
> Commitment to professional and social responsibility > Accountability for personal and professional contribution > Respect for diversity of and among colleagues and clients > Integrity in exemplifying the highest standards in personal and professional behavior > Nursing excellence for quality outcomes in practice, education, research, advocacy, and management > Generation of knowledge to enhance the science and practice of nursing to improve the health of women and newborns
What should be done when a woman reports Intimate Partner Violence? [ABCDES]
> A: Alone -- reassure her that she is not alone > B: Belief -- articulate your belief in her > C: Confidentiality -- Reassure her that this is confidential, but inform her of manditory reporting laws > D: Documentation -- Take photographs, verbatim acocunts, and objective findings > E: Education -- Inform her of resources (legal and social services) > S: Safety -- The most dangerous time for a woman experiencing IPV is when she seeks help
What six symptoms should the nurse educate a woman in the first trimester of pregnancy to immediately seek her provider upon encountering, and why?
> Abdominal cramping or pain can indicate possible threatened abortion, UTI, or appendicitis > Vaginal spotting or bleeding indicates possible threatened abortion > Absence of fetal heart tone indicates possible missed abortion > Dysuria, frequency, and urgency indicate possible UTI > Fever or chills indicate possible infection > Prolonged nausea and vomiting indicate possible hyperemesis gravidarum and pose a risk of dehydration
What are six warning/danger signs during the second trimester?
> Abdominal or pelvic pain indicates possible preterm labor (PTL), UTI, pyelonephritis, or appendicitis. > Absence of fetal movement once the woman has been feeling daily movement indicates possible fetal distress or death. > Prolonged nausea and vomiting indicates possible hyperemesis gravidarum; at risk for dehydration. > Fever and chills indicates possible infection. > Dysuria, frequency, and urgency indicate possible UTI. > Vaginal bleeding indicates possible infection, friable cervix due to pregnancy changes, placenta previa, abruptio placenta, or PTL.
What are the two steps for collecting semen in order to screen it for potential causes of infertility?
> Abstain from ejaculating for 2-3 days pre-collection > Collect the specimen at the site or within one hour
What are the six presumptive signs of pregnancy?
> Amenorrhea > Nausea and Vomiting (NVP! NVP!) > Breast changes > Fatigue > Urinary frequency increased > Quickening
What are the 9 highest risk factors for female infertility? [A seed hoop]
> Autoimmune disease > STIs > Excessive alcohol use > Exessive exercise > Diabetes > History of cancer with gonadotropic or pelvic radiation therapy > Obesity > Older age > Poor nutrition
What seven items should be found on a preconception blood serum test?
> Blood type and Rh factor > CBC > cholesterol > glucose > Rubella antibodies > STIs
